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Kidney Week

Abstract: TH-PO786

Outcomes of Maintenance Dialysis in Children Younger Than 24 Months: A NAPRTCS Report

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Menon, Shina, Seattle Children's Hospital, Seattle, Washington, United States
  • Smith, Jodi M., Seattle Children's Hospital, Seattle, Washington, United States
  • Martz, Karen, NAPRTCS, Rockville, Maryland, United States
  • Munshi, Raj P., Seattle Children's Hospital, Seattle, Washington, United States
Background

Peritoneal dialysis (PD) is the preferred mode of renal replacement therapy (RRT) in infants and young children with end-stage renal disease (ESRD). Hemodialysis (HD) is less used due to technical challenges and risk of complications in smaller patients. There are limited data on the impact of different dialysis modalities on clinical outcomes in this group

Methods

Data were extracted from the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) registry. Demographic, clinical, and laboratory data on patients < 24 months age between January 1992 and December 2018 were analyzed. We compared patient survival and access to kidney transplantation using log rank test between children treated with PD or HD

Results

1014 infants initiated dialysis therapy on PD; 114 on HD. Mean(SD) age at PD onset was 6.9 (6.8) months and at HD onset was 12.0 (7.2) months. Infants treated with PD more often had congenital anomalies of the kidney and urinary tract/obstructive uropathy (55% vs 40%, p<0.05). At 1, 6 and 12 months post dialysis onset, PD patients had significantly lower serum albumin (Figure 1). Hemoglobin was lower in HD patients at 1 and 6 months, but similar at 12 months between the groups. Time to transplant was lower for HD patients, but patient survival on dialysis was similar (Figure 2)

Conclusion

Although HD is not first line modality for RRT in younger children, 10% of children < 2years age start maintenance dialysis on HD therapy. Patients starting HD are more likely to be older and non-white. Patient survival on dialysis is similar irrespective of dialysis modality

Patient Characteristics

Time to transplant and survival on dialysis